Quantitative and Qualitative Method: Added Value in Evaluating Electronic Patient Records

Abstract

Contrary to what would be expected, the increasing application of patient care information systems hardly resulted in well-defined, methodical purchase or development and implementation trajectories. Together with the lack of thorough evaluations in daily practice, this was an important motivation to the development, implementation and evaluation of the studied electronic patient record. It is a problem that both successful and failed electronic patient record projects are seldom evaluated. This is a problem, because failures and successes can provide relevant information about system qualities, system requirements, important aspects of implementations, and so forth. A second problem is that the methods to evaluate are not yet fully developed as well as the content of evaluations. Clearly, this impedes evaluation practices. To contribute to solutions for both problems we did a case study in the field of neurology. We developed, implemented and evaluated an electronic patient record for stroke with qualitative and quantitative methods. The evaluation started before the development phase and ended after a trial period in daily practice. It was based on an evaluation framework (van der Meijden, Tange, Troost, & Hasman, 2003). The results of the evaluation showed that the previously described framework was applicable in evaluating electronic patient records. It was possible to assess attributes that represented the quality of record keeping, the impact on daily work, the opinions of nurses and physicians about electronic record keeping and the experiences of management. The analysis of these attributes provides insight in why the electronic patient record was successful in some aspects and was less successful in others. They also showed that the combination of questionnaires, interviews, chart reviews and observations in an evaluation provided deeper insight in reasons for use or non-use of an electronic patient record than one single method would have. Results collected with one method can supplement result– regarding the same subject–collected with another method.